Infusional cyclophosphamide, doxorubicin and etoposide in HIV-related non-hodgkin's lymphoma: A follow-up report of a highly active regimen

Joseph A. Sparano, Peter H. Wiernik, Margery Strack, Andrea Leaf, Norwin H. Becker, Catherine Sarta, Douglas Carney, Richard Elkind, Maya Shah, Edward S. Valentine, Janice P. Dutcher

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Based on our prior data suggesting a therapeutic advantage for infusional administration of cyclophosphamide (C), doxorubicin (D), and etoposide (E) in patients with relapsed and resistant non-Hodgkin's lymphoma (NHL), we administered C (750 mg/m2), D (50 mg/m2), and E (240 mg/m2) via continuous intravenous infusion over 96 hours as first line therapy for 21 patients with intermediate- or high-grade non-Hodgkin's lymphoma associated with human immunodeficiency virus (HIV) infection. Treatment was repeated every 28 or more days. The median CD4 count of the study group was 87/ul, and the median serum lactate dehydrogenase was 383 IU/L. Extranodal disease, lymphomatous marrow involvement, and lymphomatous meningitis were present at diagnosis in 90% 33% and 10% of patients, respectively. Complete response (CR) occurred in 13 patients (62% 95% confidence intervals 41% 81% and partial response occurred in five patients (24% The estimated median survival of the study group was 18.0 months. Hematologic toxicity required dose reduction for 47% of cycles and for 79% of patients who received at least two cycles. The mean dose intensity for C., D., and E were 73% 70% and 73% of the intended dose intensity, respectively. Opportunistic infection included oral/esophageal candidiasis (N = 7), herpes labialis (N = 3), pulmonary Mycobacterium avium-intracellulare (N = 1), candidemia (N = 1), pneumonitis (N = 1), and disseminated aspergillosis than resulted in a single treatment-related death (5% Treatment resulted in a significant decrease in the CD4+ lymphocytes, as well as total lymphocytes, T lymphocytes, and CD8+ lymphocytes. Our findings suggest that infusional CDE is a highly active regimen capable of producing durable CRs in a substantial proportion of patients with HIV-related NHL and requires further study.

Original languageEnglish (US)
Pages (from-to)263-271
Number of pages9
JournalLeukemia and Lymphoma
Volume14
Issue number3-4
DOIs
StatePublished - 1994

Keywords

  • AIDS
  • HIV
  • Infusional
  • Non-Hodgkin's lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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